A new cross-national study reveals that older adults with disabilities are significantly less likely to receive preventive care, such as flu vaccinations, eye exams, and dental checkups. This gap remains the same for eye exams and dental care but is eliminated for flu vaccinations in countries that invest more in public healthcare.

Based on data from nearly 47,000 individuals across 27 high- and middle-income countries, the study shows a strong correlation between higher government health spending and increased access to preventive services, particularly among vulnerable populations. The findings highlight the critical role of healthcare funding in promoting equitable preventive care and point to the need for targeted policies that combine investment with disability support to ensure healthier, more inclusive aging.

A new study, led by Dr. Sharona Tsadok Rosenbluth, a Lady Davis postdoctoral fellow at The Hebrew University of Jerusalem and the Faculty of Health Sciences at Ben-Gurion University of the Negev, in collaboration with Dr. Shmuli Bramli-Greenberg of The Hebrew University of Jerusalem, who is a scholar in the field of health economical inequalities and Dr. Boaz Hovav of the Max Stern Yezreel Valley College, has uncovered how national healthcare investment can make—or break—quality of life for aging populations.

Published in the Journal of Public Health, the research reveals a clear link between government health spending and the use of preventive care—such as flu shots, eye exams, and dental visits—especially among people over 50.

The findings are based on data from nearly 47,000 adults across 27 high- and middle-income countries, gathered through the large-scale European SHARE survey (pre-COVID). The study used a multi-level statistical model to analyze how both personal disability levels and national healthcare funding impact preventive care utilization.

Prevention Makes the Difference

Preventive care is widely acknowledged as a cornerstone of healthy aging. But access to it is not equal—especially for those with disabilities.

The study found that individuals with disabilities were significantly less likely to receive routine preventive care, including flu vaccines, eye checks, and dental exams. However, in countries that invest more in public health, this disparity shrinks.

In particular:

• Flu vaccine rates ranged from just 3% to 60% across countries.
• Eye exams varied from 17% to 77%.
• Dental care ranged from 14% to 86%.
• Disability prevalence also varied significantly, from 7% to 26%.

Interestingly, the data showed that in countries with high health spending, older adults with higher disability levels were more likely to receive flu vaccines, bucking the trend seen in lower-funded systems.

For eye exams and dental checkups, however, the gap between disabled and non-disabled people remained unchanged—even in countries with high investment in public health—though the overall baseline in those countries is significantly better. Flu vaccination told a different story: in higher-spending countries, vaccination rates rose for everyone, but the gap not only narrowed, it reversed at a spending level of 8.8% of GDP—with disabled adults actually receiving more flu shots than their non-disabled peers.

“This tells us that smart, targeted healthcare investment really can protect vulnerable populations and improve quality of life in old age,” said Dr. Tsadok Rosenbluth. “But we still have a long way to go—especially in addressing inequities for people living with disability.”

Policy Matters
The study underscores that system-level factors, like public health funding, are just as important as individual-level ones when it comes to preventive care access. Without strong investment, even well-intentioned health recommendations can leave behind the very people who need care most.

Bottom Line

• Disability is a barrier to preventive care in many countries.
• More public health spending means greater access to vaccines, dental checkups, and eye care.
• Flu vaccines buck the trend: in well-funded countries, people with disabilities are actually more likely to get vaccinated.
• Smart policies that combine healthcare investment with support for the disabled can ensure healthier, more dignified aging.

As governments worldwide face the challenges of aging populations, this research offers a roadmap for reducing preventable health problems—and ensuring that everyone, regardless of ability, can age with dignity and better health.